烧伤幸存者无烟草尼古丁依赖的负担：急性并发症和长期发病率
The burden of tobacco-free nicotine dependence in burn survivors: Acute complications and long-term morbidity.
摘要(中文译文)
无烟来源的尼古丁使用（如电子烟、口腔袋装制品和口香糖）已日益普遍。虽然烟草已被确认为损害伤口愈合的因素，但无烟尼古丁依赖（TFND）与烧伤后并发症之间的关系尚未明确。本研究旨在评估TFND对烧伤幸存者短期和长期并发症的影响。采用多所医疗机构电子健康记录进行了一项回顾性二次数据库队列研究。纳入18岁及以上烧伤并伴有TFND的患者，与不伴TFND的烧伤患者进行比较。估算倾向性评分，并针对社会人口学特征、合并症、烧伤特征和治疗方式按1：1进行匹配。匹配队列之间的结局包括90天伤口并发症和医疗资源利用情况，并评估90天和1年死亡率，以及1年新发阿片类药物使用障碍。统计学显著性设定为p<0.05。匹配后，每组各纳入20，906例患者。在90天时，与匹配对照组相比，TFND与更高的脓毒症、伤口裂开、感染、抗菌药物处方、急诊就诊和死亡率相关（均p<0.05）。在1年时，TFND与更高的死亡率和被诊断为阿片类药物使用障碍相关（均p<0.005）。无烟尼古丁依赖通过增加发生伤口并发症、医疗资源利用、死亡和阿片类药物使用障碍的风险，恶化烧伤结局。对电子烟和无烟尼古丁产品进行常规筛查，并配合早期戒烟咨询，可能提高生存率和促进烧伤康复。
Abstract
Nicotine use from tobacco-free sources (e.g., electronic cigarettes, oral pouches, and gum) has become prevalent. While tobacco is an established detriment for wound healing, the relationship between tobacco-free nicotine dependence (TFND) and post-burn morbidities has not been defined. This study sought to assess the impact of TFND on short- and long-term complications in burn survivors. A retrospective secondary database cohort study was conducted using electronic health records from multiple health institutions. Patients (18 + years) with burn injury and TFND were identified and compared to burned patients without TFND. Propensity scores were estimated, and 1:1 matching was performed for sociodemographics, comorbidities, burn characteristics, and treatment modalities. Outcomes between matched cohorts included 90-day wound complications and healthcare utilization, with mortality assessed at 90 days and 1 year, as well as new-onset opioid use disorder at 1 year. Statistical significance was set to p < 0.05. Following matching, 20,906 patients were included per cohort. At 90 days, TFND was associated with higher rates of sepsis, wound dehiscence, infection, antimicrobial prescriptions, emergency department visits, and mortality compared with matched controls (all p < 0.05). At 1 year, TFND was associated with elevated rates of mortality and being diagnosed with opioid use disorder (both p < 0.005). Tobacco-free nicotine dependence worsens burn outcomes by increasing the risk of developing wound complications, healthcare utilization, mortality, and opioid use disorder. Routine screening for electronic cigarettes and smokeless nicotine products, paired with early cessation counseling, may enhance survival and burn recovery.
如何引用
AMA
Matthew Q Dao, Anika Y Kim, Sarah Wang, Paul Won, Eloise W Stanton, Haig A Yenikomshian, et al. The burden of tobacco-free nicotine dependence in burn survivors: Acute complications and long-term morbidity.. Burns : journal of the International Society for Burn Injuries. 2026; doi:10.1016/j.burns.2026.108175.
APA
Matthew Q Dao, Anika Y Kim, Sarah Wang, Paul Won, Eloise W Stanton, Haig A Yenikomshian, et al (2026). The burden of tobacco-free nicotine dependence in burn survivors: Acute complications and long-term morbidity.. Burns : journal of the International Society for Burn Injuries. https://doi.org/10.1016/j.burns.2026.108175
GB/T 7714
Matthew Q Dao, Anika Y Kim, Sarah Wang, Paul Won, Eloise W Stanton, Haig A Yenikomshian, et al. The burden of tobacco-free nicotine dependence in burn survivors: Acute complications and long-term morbidity.[J]. Burns : journal of the International Society for Burn Injuries, 2026 doi:10.1016/j.burns.2026.108175.
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